ESTRADIOL, GONADOTROPINS, AND TUMOR-MARKERS IN OVARIAN-CYST FLUID

Background The study was designed to improve the discrimination betwee n functional and neoplastic ovarian cysts in order to avoid unnecessar y surgery, Methods. Concentrations of tumor markers (CA 125, CEA, CASA , CA 72-4) and hormones (estradiol, FSH, LH) in cyst fluid were detect ed by enzyme immune- or immunoradiometric assays. Wilcoxon test was us ed to evaluate the correlation of cyst fluid markers and histology. Re sults. One hundred and thirty-eight ovarian cyst aspirates were invest igated. Seventy-one patients (51.5%) had functional cysts whereas 67 ( 48.5%) had benign (n=59) or malignant (n=8) cystic tumors. Statistical ly significant correlations of CA 125 (p<0.0005) and CASA (p<0.02) wit h neoplastic histology were found. No significant correlation could be detected between CA 72-4, CEA, or hormone values and histology. Eleva ted estradiol concentrations are suspicious for functional cysts in pr emenopausal age. Low FSH and LH levels seem to be an indicator for fun ctional cysts in peri- and postmenopausal age. Conclusions. The assess ed analytes could not reliably distinguish between functional and neop lastic ovarian cysts. Our results indicate that CA 125 is a marker for neoplastic histology in a proportion of ovarian cysts. The use of FSH and LH in the diagnosis of postmenopausal blastomas needs further inv estigation.